Individual provider Active NPI

Bria Shae Mulholland, RN

  • General Practice Registered Nurse
  • Charlotte, NC
National Provider Identifier
1689454258
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
203695 Issued in NC
Practice address
4525 Cameron Valley Pkwy Ste 4100
Charlotte, NC 28211-4378
Phone
(704) 302-9462
Fax
(704) 302-9402
NPI assigned
Oct 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 203695 NC Primary

Addresses

Primary practice location

4525 Cameron Valley Pkwy Ste 4100
Charlotte, NC 28211-4378

Mailing address

4525 Cameron Valley Pkwy Ste 4100
Charlotte, NC 28211-4378
Phone (704) 302-9462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
203695NCMDGeneral Practice Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1689454258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 CAMERON VALLEY PKWY STE 4100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114378",
            "telephone_number": "704-302-9462",
            "fax_number": "704-302-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 CAMERON VALLEY PKWY STE 4100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114378",
            "telephone_number": "704-302-9462",
            "fax_number": "704-302-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULHOLLAND",
        "first_name": "BRIA",
        "middle_name": "SHAE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NC",
            "license": "203695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.